William J. MayoCo-founder with his brother Charles H. Mayo of the Mayo Clinic in Rochester, Minnesota

William J. Mayo, MD, FACS (1861–1939), and his brother Charles H. Mayo, MD, FACS (1865–1939), remain two of the most remarkable individuals in American surgery—a field with no shortage of notable individuals. With their father, William Worrall Mayo, MD (1819–1911), they built a great medical institution from a small-town general practice.1 By the early 1900s, they had established themselves among the leaders in American surgery. Both would be actively involved in the American College of Surgeons (ACS) from its founding.

Apart from his term as President of the College from 1916 to 1918, William J. Mayo held no official position in the ACS. Nonetheless, through his close friendship with ACS founder Franklin H. Martin, MD, FACS—dating from a meeting in St. Paul, MN, in 1893—he remained a consequential figure in College affairs. Over the years, the Martins were frequent guests on Dr. Mayo’s riverboats, which became a venue for discussing ACS business.

Conflicts with the AMA

In 1913, the newly formed College posed a significant challenge to the American Medical Association (AMA) and its ambition to be the sole representative of American medicine. An intense personal animosity between Dr. Martin and Arthur Dean Bevan, MD, FACS, a founder of the ACS and an AMA leader, deepened the rift. As a strong supporter of the College and its mission, Dr. Mayo also deplored “the little petty back-biting [and] personal enmities” that threatened what he saw as “the greatest movement for American surgery.”2 He devoted much of his term as ACS President to working to improve the relationship between the AMA and the ACS. Despite their friendship, however, Dr. Martin rejected Dr. Mayo’s recommendation that the ACS turn hospital standardization over to the AMA, and peace between Dr. Martin and the AMA leadership remained elusive.

Achieving international recognition

Drs. Martin (far left), William Mayo (third from right), and Charles Mayo (far right) on the North Star

Dr. Mayo had greater success helping Dr. Martin to position the ACS as an international organization. As Past-President, he accompanied Dr. Martin on an official trip to Panama, Peru, Chile, Argentina, and Uruguay in 1920, where they met with presidents as well as leading surgeons and health officials.3 A number of prominent South American surgeons received Fellowship in the College, establishing a connection that endures to this day. The voyage also helped to solidify the friendship between Dr. Mayo and Dr. Martin and to overcome any ill feelings resulting from Dr. Mayo’s editorial role on the AMA’s new journal, Archives of Surgery.

Their New Zealand and Australian “vacation,” as Dr. Martin referred to it, in 1924 had similar far-reaching results. The warm public reception throughout both countries owed much to the star quality of the Mayo name, to Dr. Mayo’s embarrassment and Dr. Martin’s chagrin. More significantly, their visit inspired leading surgeons in both countries who were considering their own surgical association.

Franklin Martin, MD, FACS,Founder of the American College of Surgeons

A year later, several Australian surgeons visited Rochester, MN, after receiving College Fellowships. While on Dr. Mayo’s boat, the North Star, they obtained characteristically succinct advice: “My boy[s], go home and found your own College.”4 So they did—the Royal Australasian College of Surgeons.

The last act

By the early 1930s, an aging Dr. Martin faced growing criticism of his leadership, particularly from a new generation of full-time teachers of surgery. Perhaps Dr. Mayo’s greatest contribution to the College was to use his own leadership transition at the Mayo Clinic to encourage Dr. Martin to accept a succession plan.5 Only Dr. Martin’s death a few months later disrupted the transition.